Improvement of intradialytic arrhytmias after combined conductivity and ultrafiltration profiling without secondary overhydration
Mejoría de arritmias intradilíticas tras aplicación de perfiles combinados de conductividad y ultrafiltración sin expansión de volumen secundaria
Read
5743
Timeswas read the article
1872
Total PDF
3871
Total HTML
Share statistics
array:21 [ "pii" => "X2013251408004343" "issn" => "20132514" "doi" => " " "estado" => "S300" "fechaPublicacion" => "2008-12-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2008;28:661-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2706 "formatos" => array:3 [ "EPUB" => 230 "HTML" => 2074 "PDF" => 402 ] ] "Traduccion" => array:1 [ "es" => array:17 [ "pii" => "X0211699508004346" "issn" => "02116995" "doi" => " " "estado" => "S300" "fechaPublicacion" => "2008-12-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia. 2008;28:661-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 6421 "formatos" => array:3 [ "EPUB" => 262 "HTML" => 5656 "PDF" => 503 ] ] "es" => array:11 [ "idiomaDefecto" => true "titulo" => "Mejoría de arritmias intradilíticas tras aplicación de perfiles combinados de conductividad y ultrafiltración sin expansión de volumen secundaria" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "661" "paginaFinal" => "662" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Improvement of intradialytic arrhytmias after combined conductivity and ultrafiltration profiling without secondary overhydration" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alvaro Molina Ordás, Rosa Sánchez Hernández, María José Fernández- Reyes Luis, Manuel Heras Benito" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Alvaro" "apellidos" => "Molina Ordás" ] 1 => array:2 [ "nombre" => "Rosa" "apellidos" => "Sánchez Hernández" ] 2 => array:2 [ "nombre" => "María José" "apellidos" => "Fernández- Reyes Luis" ] 3 => array:2 [ "nombre" => "Manuel" "apellidos" => "Heras Benito" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "X2013251408004343" "doi" => " " "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251408004343?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699508004346?idApp=UINPBA000064" "url" => "/02116995/0000002800000006/v0_201502091415/X0211699508004346/v0_201502091415/es/main.assets" ] ] "itemSiguiente" => array:17 [ "pii" => "X2013251408004335" "issn" => "20132514" "doi" => " " "estado" => "S300" "fechaPublicacion" => "2008-12-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2008;28:662-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3106 "formatos" => array:3 [ "EPUB" => 253 "HTML" => 2354 "PDF" => 499 ] ] "en" => array:11 [ "idiomaDefecto" => true "titulo" => "Large kidney due to levofloxacin" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "662" "paginaFinal" => "663" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nefromegalia por levofloxacino" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jesus Javier Castellanos Monedero, Jose Luis Rodriguez Garcia, Minerba Arambarri Segura, Agustin Carreño Parrilla, Julia Blanco" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Jesus Javier" "apellidos" => "Castellanos Monedero" ] 1 => array:2 [ "nombre" => "Jose Luis" "apellidos" => "Rodriguez Garcia" ] 2 => array:2 [ "nombre" => "Minerba" "apellidos" => "Arambarri Segura" ] 3 => array:2 [ "nombre" => "Agustin" "apellidos" => "Carreño Parrilla" ] 4 => array:2 [ "nombre" => "Julia" "apellidos" => "Blanco" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699508004338" "doi" => " " "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699508004338?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251408004335?idApp=UINPBA000064" "url" => "/20132514/0000002800000006/v0_201502091634/X2013251408004335/v0_201502091634/en/main.assets" ] "itemAnterior" => array:17 [ "pii" => "X2013251408004351" "issn" => "20132514" "doi" => " " "estado" => "S300" "fechaPublicacion" => "2008-12-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2008;28:660-1" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3118 "formatos" => array:3 [ "EPUB" => 254 "HTML" => 2380 "PDF" => 484 ] ] "en" => array:11 [ "idiomaDefecto" => true "titulo" => "Extravascular misplacement of the tunneled hemodialysis catheter" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "660" "paginaFinal" => "661" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Inserción extravascular del catéter tunelizado para hemodiálisis" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "MARÍA JESÚS CASTRO-VILANOVA, BEATRIZ MILLÁN, DANIEL NOVOA, VÍCTOR ARCOCHA" "autores" => array:4 [ 0 => array:2 [ "nombre" => "MARÍA JESÚS" "apellidos" => "CASTRO-VILANOVA" ] 1 => array:2 [ "nombre" => "BEATRIZ" "apellidos" => "MILLÁN" ] 2 => array:2 [ "nombre" => "DANIEL" "apellidos" => "NOVOA" ] 3 => array:2 [ "nombre" => "VÍCTOR" "apellidos" => "ARCOCHA" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699508004354" "doi" => " " "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699508004354?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251408004351?idApp=UINPBA000064" "url" => "/20132514/0000002800000006/v0_201502091634/X2013251408004351/v0_201502091634/en/main.assets" ] "en" => array:11 [ "idiomaDefecto" => true "titulo" => "Improvement of intradialytic arrhytmias after combined conductivity and ultrafiltration profiling without secondary overhydration" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "661" "paginaFinal" => "662" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Alvaro Molina Ordás, Rosa Sánchez Hernández, María José Fernández- Reyes Luis, Manuel Heras Benito" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Alvaro" "apellidos" => "Molina Ordás" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "nombre" => "Rosa" "apellidos" => "Sánchez Hernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 2 => array:3 [ "nombre" => "María José" "apellidos" => "Fernández- Reyes Luis" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 3 => array:3 [ "nombre" => "Manuel" "apellidos" => "Heras Benito" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => " HospitalGeneral de Segovia Segovia Segovia España, " "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Mejoría de arritmias intradilíticas tras aplicación de perfiles combinados de conductividad y ultrafiltración sin expansión de volumen secundaria" ] ] "textoCompleto" => "To the editor: Hemodynamic instability (arrhythmias, hypotension) is one of the most frequent complications found during dialysis. For years, the usefulness of ultrafiltration and/or conductivity profiling to prevent the appearance of such problems has been the subject of debate. <br></br><br></br>We report the case of a 75-year-old male initially subjected to peritoneal dialysis due to chronic renal failure secondary to diabetic kidney disease who required transfer to hemodialysis because of peritonitis, with a poor course one year after treatment. After starting hemodialysis, and as a result of nutritional problems, dry weight began to decrease (over 4 kg), with good hemodynamic tolerance. However, after two months the heart rate ¿ which at the start of the session was 60-70 bpm ¿ suddenly increased in the last hour to 110-120 bpm. In some cases this situation was accompanied by severe hypotension. Continuous electrocardiographic monitorization of several hemodialysis sessions was thus decided. In the first three hours the patient showed sinus rhythm with a heart rate of 60-70 bpm, though after the third hour rapid atrial fibrillation was recorded that only reverted after conclusion of the dialysis session. The previous and posterior blood pressure values remained at 120- 130/70-80 mmHg. In view of this situation, the dialysis machine conductivity and ultrafiltration parameters were changed during the session, applying a descending logarithmic profile for conductivity (start 15.7 mS/cm, end 13.8 mS/cm) and ultrafiltration (dialysis previously being carried out with a constant conductivity of 14.2 mS/cm). This measure improved tolerance during the sessions, with no severe hypotension and presenting a stable heart rate. Over the following four months the patient gained 2 kg in dry weight, but the blood pressure did not increase (110-120/70 <br></br>mmHg); no antihypertensive medication was needed, and no edema or other signs of volume expansion were noted. Likewise, there were no increases in pre-dialysis sodium level (134-135 mEq/l in the determinations with constant conductivity at 14.2 mS/cm versus 135 mEq/l in those made with the exponential profile). <br></br><br></br>The use of conductivity and ultrafiltration profiling during hemodialysis has been studied by a number of authors. The objective of such profiling is to improve hemodynamic tolerance by preventing vascular depletion secondary to sodium loss during dialysis.1 However, the different series found in the literature report quite variable results ¿ reflecting the use in many cases of very different profiles. Some studies have reported no significant differences in <br></br>hemodynamic tolerance on applying combined conductivity and ultrafiltration profiles.2 Other studies involving linear profiles starting with high conductivities (15-15.5 mS/cm) and ending with values close to 14 mS/cm have observed a reduction in hypotensive episodes ¿ though at the expense of an increased volume expansion (increase in blood pressure before and after dialysis).3-5 <br></br><br></br>In other cases the applied profile exhibited end conductivity values lower than those of the serum sodium concentration before dialysis. In this way elimination is secured of the excess sodium that may have diffused in the first phase of the dialysis session, achieving a neutral balance without inducing volume expansion.6,7 <br></br><br></br>Likewise, series have been published in which conductivity and ultrafiltration begin at very high values close to 15.8-15.9 mS/cm, followed by a rapid exponential reduction until ending at values close to 14 mS/cm. In this way most of the ultrafiltration takes place in the first moments of the session, when conductivity is very high, though on quickly reducing the sodium concentration, accumulation and subsequent overhydration are avoided.8 <br></br><br></br>In sum, the use of combined conductivity and ultrafiltration profiling may prove useful for controlling hemodynamic <br></br>instability (arrhythmias, hypotension) during hemodialysis, though great care is required on selecting the starting and ending conductivities, in order to avoid volume expansion. <br></br>" "pdfFichero" => "P-E-S-A346-EN.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "Sr Director: La inestabilidad hemodinámica ( arritmias, hipotensión) durante la sesión de diálisis es una de las principales complicaciones del tratamiento. Desde hace años se ha discutido la utilidad de la aplicación de perfiles de ultrafiltración y / o conductividad para prevenir su aparición. " ] "en" => array:1 [ "resumen" => "To the editor: Hemodynamic instability (arrhythmias, hypotension) is one of the most frequent complications found during dialysis. For years, the usefulness of ultrafiltration and/or conductivity profiling to prevent the appearance of such problems has been the subject of debate." ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002800000006/v0_201502091634/X2013251408004343/v0_201502091634/en/main.assets" "Apartado" => array:4 [ "identificador" => "35436" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000002800000006/v0_201502091634/X2013251408004343/v0_201502091634/en/P-E-S-A346-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251408004343?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 16 | 10 | 26 |
| 2024 October | 40 | 27 | 67 |
| 2024 September | 46 | 29 | 75 |
| 2024 August | 46 | 53 | 99 |
| 2024 July | 46 | 27 | 73 |
| 2024 June | 56 | 31 | 87 |
| 2024 May | 44 | 28 | 72 |
| 2024 April | 47 | 32 | 79 |
| 2024 March | 30 | 25 | 55 |
| 2024 February | 27 | 31 | 58 |
| 2024 January | 26 | 16 | 42 |
| 2023 December | 18 | 26 | 44 |
| 2023 November | 44 | 30 | 74 |
| 2023 October | 28 | 34 | 62 |
| 2023 September | 59 | 26 | 85 |
| 2023 August | 39 | 24 | 63 |
| 2023 July | 50 | 28 | 78 |
| 2023 June | 35 | 13 | 48 |
| 2023 May | 30 | 26 | 56 |
| 2023 April | 20 | 13 | 33 |
| 2023 March | 26 | 12 | 38 |
| 2023 February | 15 | 15 | 30 |
| 2023 January | 24 | 21 | 45 |
| 2022 December | 43 | 26 | 69 |
| 2022 November | 22 | 25 | 47 |
| 2022 October | 33 | 23 | 56 |
| 2022 September | 29 | 31 | 60 |
| 2022 August | 33 | 42 | 75 |
| 2022 July | 39 | 38 | 77 |
| 2022 June | 24 | 23 | 47 |
| 2022 May | 32 | 26 | 58 |
| 2022 April | 33 | 36 | 69 |
| 2022 March | 29 | 34 | 63 |
| 2022 February | 26 | 35 | 61 |
| 2022 January | 57 | 31 | 88 |
| 2021 December | 24 | 34 | 58 |
| 2021 November | 28 | 41 | 69 |
| 2021 October | 32 | 45 | 77 |
| 2021 September | 37 | 37 | 74 |
| 2021 August | 25 | 28 | 53 |
| 2021 July | 26 | 37 | 63 |
| 2021 June | 20 | 27 | 47 |
| 2021 May | 19 | 27 | 46 |
| 2021 April | 42 | 52 | 94 |
| 2021 March | 50 | 37 | 87 |
| 2021 February | 24 | 16 | 40 |
| 2021 January | 18 | 22 | 40 |
| 2020 December | 19 | 9 | 28 |
| 2020 November | 20 | 12 | 32 |
| 2020 October | 16 | 15 | 31 |
| 2020 September | 18 | 8 | 26 |
| 2020 August | 23 | 10 | 33 |
| 2020 July | 34 | 7 | 41 |
| 2020 June | 20 | 19 | 39 |
| 2020 May | 27 | 9 | 36 |
| 2020 April | 31 | 14 | 45 |
| 2020 March | 22 | 13 | 35 |
| 2020 February | 32 | 16 | 48 |
| 2020 January | 30 | 21 | 51 |
| 2019 December | 29 | 24 | 53 |
| 2019 November | 18 | 16 | 34 |
| 2019 October | 8 | 5 | 13 |
| 2019 September | 19 | 12 | 31 |
| 2019 August | 13 | 6 | 19 |
| 2019 July | 13 | 19 | 32 |
| 2019 June | 14 | 1 | 15 |
| 2019 May | 8 | 7 | 15 |
| 2019 April | 35 | 21 | 56 |
| 2019 March | 15 | 8 | 23 |
| 2019 February | 9 | 12 | 21 |
| 2019 January | 22 | 17 | 39 |
| 2018 December | 50 | 21 | 71 |
| 2018 November | 52 | 16 | 68 |
| 2018 October | 55 | 9 | 64 |
| 2018 September | 36 | 10 | 46 |
| 2018 August | 33 | 16 | 49 |
| 2018 July | 28 | 7 | 35 |
| 2018 June | 28 | 10 | 38 |
| 2018 May | 26 | 10 | 36 |
| 2018 April | 20 | 5 | 25 |
| 2018 March | 27 | 6 | 33 |
| 2018 February | 23 | 3 | 26 |
| 2018 January | 14 | 4 | 18 |
| 2017 December | 33 | 9 | 42 |
| 2017 November | 13 | 2 | 15 |
| 2017 October | 30 | 9 | 39 |
| 2017 September | 19 | 14 | 33 |
| 2017 August | 24 | 5 | 29 |
| 2017 July | 28 | 8 | 36 |
| 2017 June | 22 | 5 | 27 |
| 2017 May | 25 | 7 | 32 |
| 2017 April | 20 | 6 | 26 |
| 2017 March | 13 | 4 | 17 |
| 2017 February | 26 | 7 | 33 |
| 2017 January | 17 | 6 | 23 |
| 2016 December | 19 | 3 | 22 |
| 2016 November | 22 | 5 | 27 |
| 2016 October | 53 | 6 | 59 |
| 2016 September | 51 | 2 | 53 |
| 2016 August | 95 | 2 | 97 |
| 2016 July | 103 | 4 | 107 |
| 2016 June | 94 | 0 | 94 |
| 2016 May | 79 | 0 | 79 |
| 2016 April | 43 | 0 | 43 |
| 2016 March | 58 | 0 | 58 |
| 2016 February | 54 | 0 | 54 |
| 2016 January | 68 | 0 | 68 |
| 2015 December | 84 | 0 | 84 |
| 2015 November | 69 | 0 | 69 |
| 2015 October | 40 | 0 | 40 |
| 2015 September | 43 | 0 | 43 |
| 2015 August | 64 | 0 | 64 |
| 2015 July | 30 | 0 | 30 |
| 2015 June | 32 | 0 | 32 |
| 2015 May | 51 | 0 | 51 |
| 2015 April | 5 | 0 | 5 |
Show all
